If you have been trying unsuccessfully to have a baby, the next step is a complete infertility evaluation. Once our team has determined the cause of any problems you may be experiencing, we will recommend the best options to help you start a family.

Our state-of-the-art technologies, ability to diagnose and treat rare conditions, and the resources offered in our national fertility network means that your chances of having a healthy baby are better than ever.

But first, let’s review some initial tests that will help us to properly diagnose any issues you may be experiencing.

FERTILITY HORMONE TESTING

Female hormonal imbalances are often the key factors for impairing pregnancy. That’s because hormones control everything in a woman’s reproductive cycle: the development of an egg, when you ovulate, and how the embryo becomes implanted in your uterus. It’s a delicate dance, requiring all the steps to be followed at just the right time.

E2 (estrogen) stimulates growth of follicles, production of fertile mucus from the cervix, and prepares the uterine lining for implantation of a fertilized egg

FSH (follicle-stimulating hormone), which is released from the brain to stimulate development of the egg. High levels indicate a lower ovarian reserve, though the results can vary from month to month.

AMH (anti-Müllerian hormone), which is the most accurate predictor of the size of the ovarian reserve

Testing for Ovulation and Implantation:

LH (luteinizing hormone) stimulates release of the egg from the follicles (ovulation)

Progesteronestabilizes the uterine lining for implantation of a fertilized egg and supports early pregnancy

Testing for Other Hormonal Imbalances:

Androgens: small amounts of androgens—testosterone and DHEAS — are normally produced in women. Excess production may interfere with development of the follicles, ovulation, and cervical mucus production

Thyroid: an underactive thyroid can result in high prolactin levels

ULTRASOUNDS

Dr. Jesse Hade and our fertility team use ultrasound tests to assess your uterus, ovaries, and follicles to determine the status of your ovarian reserve. By combining the results of the hormone testing and the ultrasound with your medical history and your male partner’s test results, Dr. Hade will recommend the best treatment options.

We also use transvaginal (internal) ultrasound to:

monitor your cycle if you are taking medication to stimulate the follicles to produce multiple eggs

guides Dr. Hade during IVF as he retrieves the eggs

HYSTROSALPINGOGRAM (HSG)

Our fertility team uses an HSG x-ray test to examine the walls of your uterus and Fallopian tubes. The goal of this test is to:

see if your Fallopian tubes are open

assess the shape of your uterus

check for the presence of fibroids

SEMEN ANALYSIS

Male infertility accounts for 40% of all fertility cases. Therefore, analysis of a semen sample provides critical information that can affect a couple’s fertility chances. It is scheduled shortly after first meeting with Dr. Hade and can be performed at home or in our Scottsdale office.

This test will provide insight on the following factors:

Sperm shape: if more than 50% of the sperm are abnormally shaped, the man’s fertility will be affected.

Volume of sperm: the collected sample should be 2 millimeters. Less indicates an inadequate volume to fertilize an egg.

Sperm motility or movement: more than 50% of the sperm should still move normally an hour after ejaculation. This is important because sperm must be able to travel along the Fallopian tubes to reach the egg for fertilization.

Sperm count: a normal analysis shows between 20 million and 200 million sperm. A lower count makes it difficult to conceive.

pH level: a pH level below 7.2 or higher than 8 can indicate a medical problem such as an infection, or a blocked duct.

Liquefaction: the semen sample should turn to a watery consistency within 15 to 30 minutes from ejaculation to allow the sperm to move and conception occur.

Appearance: the sample should be whitish-gray. A reddish brown tint might indicate the presence of blood; a yellowish cast could mean a medication side effect.

What other tests are there for men?
If your semen analysis shows an abnormal result, Dr. Hade may recommend any of the following tests to determine factors affecting fertility: